To tackle problems related to public policy, policymakers use the approach of public deliberation that entails the consideration of both evidence and values. However, uncertainty regarding why and when to implement it still prevails, with individuals questioning why it is more preferred to expert panels or public opinion polls. With guidance on the when and why of public deliberation, policy-makers can appropriately use it to inform public policy.
Public deliberation is not appropriate for every policy issue. In fact, surveys, polls, and focus groups are relevant when the aim is to access the ‘general attitudes’ or ‘top of mind’ of the public, or when the issue is one that people have experience with or think about in their everyday lives. Additionally, there are purely scientific or technical matters for which experts alone should be consulted, for instance, which flu viruses may be used to make the vaccine for next year. In this article, we explore how public deliberation helps in public policy.
When is a policy issue most suited for public deliberation?
Policy issues that suit well to public deliberation have at least one of the following features: low trust in government, real-world knowledge and combined expert, high controversy, and conflicting public values.
Public deliberation is quite useful for issues where the government and the public are at odds. Public health crises, for instance, influenza pandemics, severe acute respiratory syndrome (or SARS), and mad cow disease are situations where governments, based on their response, can lose, retain, or earn the trust of the public, countering challenges to governmental or scientific legitimacy. While the notion of public trust is quite complicated and is a result of multiple factors, both local and international. Therefore, public deliberation on low-trust issues shouldn’t be considered as a solution to the numerous causes of low trust, but conducted rather appropriately, as a means to increase accountability and transparency between the public and the policy-makers. In turn, this can promote increased trust.
Hybrid topics: Combining real-world and technical knowledge
In contrast to pure technical decisions that entail consultation with experts, hybrid topics need a more general reflection on practical and cultural knowledge on how specific decisions would impact the lives of people. The decisions about bio-banking, clinical trial design, vaccination mandates, and health insurance coverage are some examples of hybrid topics.
In decision-making, it is difficult to ignore the outcomes arising as a result of negligence for cultural knowledge. If the researchers of the University of Arizona had a public deliberation to ascertain the knowledge of social risks and harms posed by addiction, mental health, and pursuing ancestry, on the Havasupai tribe, they might have been able to avoid years of loss of trust, bad publicity, and lawsuits within the research enterprise.
The public exposure to the technical knowledge concerning complicated topics yields a more informed, more productive set of views that most likely result in more viable policy recommendations. In this manner, public deliberation is distinctly relevant to hybrid topics.
Controversial and divisive topics
While public values are usually relevant to numerous public policy decisions, not every one of these values is substantially divisive and controversial. Often, policymakers are cautious about consulting the public with regards to controversial topics like public health coverage, gene therapy, stem cell research, and genetically modified foods. Most likely, these types of issues are likely to generate standoffs if they are posed to the public without relevant facilitated discussion, framing, and background information.
The debate about whether deliberation processes lead to more diverse or heterogeneous positions or tend to produce more agreement on controversial issues is quite prevalent. While there is no need for public deliberation to come up with a consensus, it has the unique ability to acknowledge the diverse problems on the topic, with the aim of collectively dealing with thorny problems.
As per our perspective, moderated and well-designed public deliberation that seeks to articulate the underlying values and respects divergent views have more probability of yielding a set of collective policy responses, even if individuals don’t seem to agree on specific issues. In cases where it is difficult to reach a consensus, the positions resulting from public deliberation are better justified and articulated than those that participants begin with because every participant must engage with and acknowledge the opposing views, providing reasons to support their individual positions.
Decisions reflecting conflicting values about the public good
Majority of the public policy decisions make use of competing values about what benefits the individuals. However, those concerning competing values about what is best for society, country, or a community benefits most from public deliberation. For instance, setting policies for population bio-banking entail weighing consent and privacy against ease of output and research; and individual control over bio-banks against risks and benefits to un-consenting individuals and communities. The significance of moving the population science forward in an effective and efficient manner, while using this information to improve medical treatments must be weighed against the values of genetic security and privacy and of limiting controversial genetic research that is in conflict with cultural, religions, or other systems of belief.
When in the policy process?
The importance of both upstream and downstream public deliberation cannot be doubted; however, their effectiveness is based on the clarity with which expectations are established initially. If people are continuously involved solely in downstream, they can never challenge the fundamental options and questions of policy decisions and are limited to select among pre-established options only. When engaged exclusively in upstream, people have the flexibility of expressing their views; however, they never impact the real policy choices directly. These tradeoffs must be weighed in by the groups taking into account public deliberation. If possible, both the upstream and downstream engagement must be taken advantage of. If not, the participants must be made clear the implications of either of choice.